Abstract
Many people in our society have been exposed to overwhelming trauma, including abuse and assault. Posttraumatic stress can persist and become a chronic disorder, with behavioral and physiologic alterations affecting health across the lifespan. Often the etiologic role of trauma in a health problem remains undiscerned and unacknowledged. Acknowledging the effects of trauma is a caring intervention in itself, and it can lead to more effective healthcare and better relationships with patients. This article describes the process of acknowledging the effects of trauma in clinical reasoning, in dialogue with the patient, and in planning care and interventions.